More people than ever are using the internet and social media for connecting with people, finding outinformation and entertainment.
In community brain injury rehabilitation, online tools, apps and smartphone features can be extremely helpful. But like with other tools, its important to understand how to use them safely, and what to do if you need help. Unfortunately, there are individuals and organisations around the world that try to scam people out of money and private information. In Australia, $107 million was stolen through scams last year (Source: Scamwatch), and the number keeps growing. Scams can happen to anyone, even those who think they are switched on to this. Romance Scams are one of the most common types, and can cause not just financial loss, but significant heartbreak and distress. People with brain injury may be additionally vulnerable as they are often looking for social connection or a relationship. Once they have been scammed,it can also be much harder torealise it was a scam and take steps to get out of it.

Dr Kate Gould is a Clinical Neuropsychologist and Monash University Research Fellow. Together with her client, Colin Brokenshire, Kate has been co-designing and delivering advocacy training about improving Cyberability after brain injury for the last four years. This work has been recognised by the ASSBI Clinical Innovation Award (2018). Funded by the Allen Martin Research Scholarship Award (2018) through the Summer Foundation, Kate is currently leading the Cyberability team in conducting a world first study into understanding and improving online safety after brain injury. Kate and Colin have joined with Anna Holliday from Li-Ve Tasmania and another consumer with lived experience, Alf Archer, to conduct an awareness building campaign on understanding, preventing and treating cyberscams after brain injury. Their series of workshops in Melbourne and Tasmania and webinar in July 2019 have been well received by the clinical community, with particular value placed on Colin and Alf’s stories of their own experiences with scams. Findings from their clinician survey and workshop evaluation will form the foundation of both clinical knowledge and practice in this new area, supporting people’s “cyberability” so that they can benefit from the safe use of technology in neurorehabilitation and their everyday life.

Information from the Editors of Brain ImpairmentDavid Andrewes and Pamela Snow, both long-time founding members of ASSBI, tendered their resignation from the Editorial Board of Brain Impairment at the last EB meeting in NZ in May. The Editors, members of the Editorial Board, Executive Committee and members of ASSBI thank them both for their service. For more info go to BI page

Chief Executive Officer's Report

FREE THINGS!Now we've got your attention: we are offering a free month of ASSBI membership for September and October only. BONUS: if you're referred by a current member, both you AND the current member will get ANOTHER free month of membership! How good is that? CLICK HERE for membership:

I’d like to thank Matthew for taking a pile of work off these shoulders, you are doing a great job Matt.

We have a new ABSTRACT SUBMISSION PORTAL, we will now be using CVENT to submit abstracts. This means that we will be using the same system across abstract submission, registration and the APP. Look out for your email invitation to submit an abstract.

Apart from ASSBI, The NR-SIG-WFNR and the CCD Bi-Annual Symposium are both opening their Call for Abstracts within the month (go to World Events). Their conferences will be held in Austria and Melbourne in July 2020.

Cheers, Margaret Eagers, CEO

NEWS ArticleWe are featuring the winner of the Douglas/Tate Prize for 2018 in this issue

Do Mild Traumatic Brain Injury Severity Sub-Classification Systems Help to Identify People Who Go on to Experience Long-Term Symptoms?What the study is aboutUp to 95% of traumatic brain injuries (TBI) are classified as being of mild severity. Whilst many individuals who have sustained a mild TBI recover naturally within a few days to weeks, up to half of those affected can experience persistent symptoms and difficulties participating in everyday activities.Consequently, there is a need to unravel the wide heterogeneity in mild TBI and identify people who are more likely to need clinical treatment to facilitate their recovery. The challenges are that classification systems need to be easy to implement within a busy clinical environment, capture the full breadth of possible presentations and have high predictive validity. This study aimed to identify sub-classification systems for mild TBI andto determine their utility in predicting outcome.What we didWe conducted a systematic review to identify mild-TBI sub-classification systems published until March 2016. Systems were included in the review if they graded mild-TBI into two or more categories, were an independent system (the most up to date version of a system was used) and did not require specialist physical assessment or MRI or CT scans (which would not be feasible to implement in a community setting.We classified a sample of 290 adults who had experienced a mild-TBI according to each of the identified sub-classification systems based on their medical records at the time of injury. Assessment data on reported post-concussion symptoms experienced at 1-year post injury collected as part of a previous research study was then extracted for these participants. A series of ANOVAs and regression models were used to determine whether each sub-classification system could distinguish between outcomes.What we foundNineteen different subclassification systems were identified as part of the review. The proportions of mild-TBI participants classified into the different sub-classification grades varied considerably between different systems. The systems were based on a range of factors including period of loss of consciousness, worst Glasgow Coma Score and acute symptoms such as headache, amnesia, vomiting and confusion. Only one classification system by Saal et al (1991) was able to significantly differentiate the experience of post-concussion symptoms 1-year post injury. However, the findings did not remain significant following correction for multiple comparisons and inclusion of socio-demographic and contextual factors in the regression model. Results from this study reveal that current sub-classification systems based on initial level of consciousness and acute symptoms fail to identify those most at risk of experiencing longer-term post-concussion symptoms. Other factors such as psychological and pre-injury variables may have more influence on longer-term outcomes from mild TBI and need to be explored.AcknowledgementsThe authors would like to thank the Health Research Council of New Zealand who funded the initialrecruitment and collection of data of the mild TBI sample.

7 Dec 2017 11:37 |
Anonymous

Do people with severe traumatic brain injury benefit from making errors? A randomized controlled trial of error-based and errorless learning.

What the study is about

Individuals who have sustained a traumatic brain injury (TBI) often need to relearn a lot of skills they had previously mastered. There is some disagreement as to the best strategy to relearn these skills, however, one method that has been successful is ‘errorless learning’. Errorless learning refers to teaching the skill without ever allowing for errors to occur. The training session is designed in a way that requires the trainer to prompt with the correct response, rather than allowing the trainee to guess, and therefore risk laying down the memory of the error response. Learning in this method is often very specific and skills do not often generalise to other situations where the skill is needed outside of the training session. Error-based learning on the other hand involves structured feedback on performance (e.g., use of videos), graded prompts, and post-task reflection to teach how to anticipate errors, check for and correct errors, and generate strategies for overcoming those errors. This ‘metacognitive’ method has previously been shown to reduce errors on trained tasks, increase self-regulation and self-awareness, however, it was previously not known if this approach would promote greater generalisation of skills than errorless learning. This study aimed to determine this.

What we did

Fifty-four individuals with a severe traumatic brain injury were randomised either to the errorless learning group OR to the error-based learning group. They received 8 x 1.5 hour individual training sessions focused on meal preparation. The success of training was measured by total errors made during the Cooking Task (a standardised test of error self-regulation), as well as measure of broader generalisation (Zoo map test) and a number of other secondary outcome measures.

What we have found

After accounting for initial performance and level of pre-injury education, individuals in the error-based learning group demonstrated significantly fewer errors on the Cooking Task following training when compared to those in the errorless learning group. Those who received the error-based training strategies also demonstrated greater levels of self-awareness and behavioural competency at completion. Forty-one participants were re-tested 6 months following completion of training. There were no significant differences in social and vocational outcomes at this point. Results from this study demonstrate that having structured opportunities to make errors and learn to correct these plays an important role in the learning of skills during rehabilitation after severe traumatic brain injury.

Acknowledgements

The authors would like to thank the willing volunteers who participated in this research. The research would also not have been possible without funding from the National Health and Medical Research Council.